Retrospective Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Diabetes. Jun 15, 2024; 15(6): 1226-1233
Published online Jun 15, 2024. doi: 10.4239/wjd.v15.i6.1226
Application of neutrophil-lymphocyte ratio and red blood cell distribution width in diabetes mellitus complicated with heart failure
Jie Pang, Lin-Yan Qian, Ping Lv, Xiao-Ru Che
Jie Pang, Lin-Yan Qian, Ping Lv, Xiao-Ru Che, Heart Center, Department of Cardiovascular Medicine, Zhejiang Provincial People’s Hospital (The Affiliated People’s Hospital), Hangzhou Medical College, Hangzhou 310014, Zhejiang Province, China
Author contributions: Pang J designed the research and wrote the first manuscript; Pang J, Qian LY, Lv P and Che XR contributed to conceiving the research and analyzing data; Pang J and Che XR conducted the analysis and provided guidance for the research; All authors reviewed and approved the final manuscript.
Supported by Zhejiang Province Traditional Chinese Medicine Science and 158 Technology Project, No. 2023ZL008.
Institutional review board statement: This study was approved by the Ethic Committee of Zhejiang Provincial People’s Hospital (Approval No. QT2023228).
Informed consent statement: This study is a retrospective study and used anonymous patients data from the past and did not pose any risks to patients, we have applied for exemption from informed consent.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Xiao-Ru Che, Doctor, Associate Chief Physician, Heart Center, Department of Cardiovascular Medicine, Zhejiang Provincial People’s Hospital (The Affiliated People’s Hospital), Hangzhou Medical College, No. 158 Shangtang Road, Gongshu District, Hangzhou 310014, Zhejiang Province, China. sananc@163.com
Received: January 25, 2024
Revised: March 4, 2024
Accepted: April 19, 2024
Published online: June 15, 2024
Processing time: 138 Days and 9.9 Hours
Abstract
BACKGROUND

Accumulating clinical evidence has shown that diabetes mellitus (DM) is a serious risk factor for cardiovascular disorders and an important factor for adverse cardiovascular events.

AIM

To explore the value of the combined determination of the neutrophil-lymphocyte ratio (NLR) and red blood cell distribution width (RDW) in the early diagnosis and prognosis evaluation of DM complicated with heart failure (HF).

METHODS

We retrospectively analyzed clinical data on 65 patients with type 2 DM (T2DM) complicated with HF (research group, Res) and 60 concurrent patients with uncomplicated T2DM (control group, Con) diagnosed at Zhejiang Provincial People’s Hospital between January 2019 and December 2021. The NLR and RDW values were determined and comparatively analyzed, and their levels in T2DM + HF patients with different cardiac function grades were recorded. The receiver operating characteristic (ROC) curves were plotted to determine the NLR and RDW values (alone and in combination) for the early diagnosis of HF. The correlation between NLR and RDW with the presence or absence of cardiac events was also investigated.

RESULTS

Higher NLR and RDW levels were identified in the Res vs the Con groups (P < 0.05). The NLR and RDW increased gradually and synchronously with the deterioration of cardiac function in the Res group, with marked differences in their levels among patients with grade II, III, and IV HF (P < 0.05). ROC curve analysis revealed that NLR combined with RDW detection had an area under the curve of 0.915, a sensitivity of 76.9%, and a specificity of 100% for the early diagnosis of HF. Furthermore, HF patients with cardiac events showed higher NLR and RDW values compared with HF patients without cardiac events.

CONCLUSION

NLR and RDW were useful laboratory indicators for the early diagnosis of DM complicated with HF, and their joint detection was beneficial for improving diagnostic efficiency. Additionally, NLR and RDW values were directly proportional to patient outcomes.

Keywords: Neutrophil-lymphocyte ratio; Red blood cell distribution width; Type 2 diabetes; Heart failure; Early diagnosis

Core Tip: This study aimed to explore the value of the combined determination of the neutrophil-lymphocyte ratio and red blood cell distribution width in the early diagnosis and prognosis evaluation of diabetes mellitus complicated with heart failure.